Federal Government Pricing File

Establish and Compare Pricing Methodologies for State Medicaid and Beyond

Get access to important drug pricing data from the Centers for Medicare & Medicaid Services (CMS) as soon as the government makes it available.

ACA FUL (Affordable Care Act Federal Upper Limit) is based on a formula detailed in the Affordable Care Act. It replaces previous pricing data point CMS FUL (Centers for Medicare and Medicaid Services Federal Upper Limit). Healthcare businesses are anticipated to use ACA FUL information to establish reimbursement for drugs covered under Medicaid.

NADAC (National Average Drug Acquisition Cost) is based on CMS’s monthly surveys of retail pharmacies to determine average acquisition cost for covered outpatient drugs.

What It Does for Your Business

  • Helps save time by
    • Eliminating manual processing of pricing updates and data output changes from the government
    • Delivering NADAC and/or ACA FUL pricing data in one resource
  • Helps reduce the risk of errors from manually gathering prices from the CMS website
  • Keeps you current with content updates as often as daily when CMS posts new price data
  • Assists payers/PBMs in considering price points when establishing contracts, particularly those involving state Medicaid
  • Helps retail pharmacies anticipate baseline pricing for state Medicaid programs
  • Supports a wide range of applications, as it links pricing data to National Drug Codes (NDCs), allowing the file to be used whether employing Medi-Span drug files or not

What It Provides

  • Ability to license ACA FUL pricing, NADAC pricing, or both within your database
  • Initial database provides access to current prices and up to 12 weeks of NADAC price history. (Up to 12 weeks of ACA FUL will be available in the database as pricing information evolves)
  • ACA FUL data includes two price points:
    • FUL – the monthly value of ACA
    • Weighted Average AMP (Average Manufacturer’s Price)
  • Content set provides indicators to Medi-Span content to identify if:
    • The NDC is on the Medi-Span drug file
    • The NDC is inactive in the Medi-Span drug file
    • The Medi-Span unit of measure differs from that defined by CMS
  • Extrapolates government NADAC and ACA FUL pricing from NDCs with CMS-published data to similar NDCs on the Medi-Span drug file that are not reported by CMS. On average, for every NDC CMS reports, Medi-Span extrapolates to an additional 1-2 NDCs, and those NDCs are readily identified and distinguished from NDCs with CMS-published data

Delivery Timing Options

  • Daily
  • Weekly
  • Monthly

Why Medi-Span?

Overall Satisfaction

98%

of customers are satisfied with the quality of Medi-Span data

Renewal Rate

99%

of customers are likely to renew their Medi-Span data license

Productivity

50%

Hundreds of customers see 50% or greater increase in productivity with Medi-Span

See why more healthcare businesses are choosing Medi-Span for their drug data:

Reasons Customers Chose and Stay

Testimonials

  • Speed to Market

    Medi-Span implementation support helped save me one month in speed to market and about $10,000 in development costs.

    Keith Streckenbach, CEO
    HighFive Health

  • Fast Results

    Medi-Span, in my view, beats everyone else. It helps you find twice as many drug errors – errors that would lead to readmission - in half the amount of time.

    Keith Streckenbach, CEO
    HighFive Health

  • Competitive Advantage

    (Medi-Span) allows us to provide features that our competitors do not have.

    Senior developer from a healthcare software vendor

  • Valuable Resource

    As a claims processor, we rely on Medi-Span and its wealth of drug information to forecast and price claims for our clients. Medi-Span is the go-to (application) that is recognized across the industry for (manufacturer-provided) drug information. They have innovative tools and excellent customer service that will go above and beyond to provide the best available solution.

    Healthcare vendor systems analyst

  • Valuable Support

    Medi-Span implementation support helped save me one month in speed to market and about $10,000 in development costs.”

    Keith Streckenbach, CEO HighFive Health

  • Consistent Pricing Data

    It is the source for the benchmark prices consistently used in the PBM industry and the tool we use to hold PBMs accountable to their pricing promises to our employers.

    Insurance company senior actuarial consultant

  • Business Essential

    Business cannot survive without Medi-Span data.

    Fortune 500 PBM clinical pharmacist

  • Key Content

    Only reliable published resource for (manufacturer-provided) AWP. (Medi-Span proprietary) GPI is therapeutic classification system of choice. It is very enabling, as clinical management rules are easily articulated.

    Chief Pharmacy Officer from a PBM

  • Provides Confidence

    Even in an era where data abounds, there is a terrific amount of uncertainty. People want confidence that what they are seeing is (based on) real (manufacturer-provided information) – Medi-Span provides that confidence.

    Health plan executive

  • Unifying Data

    (Medi-Span) allows for consistency across the company, industry and clients.

    Manager from an insurance company

  • Timely and Relevant

    The Medi-Span database allows our system to have the latest and most current information available. It is especially needed for package information, interaction checking, and clinical printing.

    Executive from a healthcare software vendor

  • Strong Foundation

    This is a foundational piece that is used throughout the organization in many systems and is often used to connect data from multiple systems.

    Systems analyst from a top-grossing PBM

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Who is Clinical Drug Information?

With the move to team-based care, conflicting data can lead to actual conflicts – from disparity in business decisions to confusion in communication. We research, validate, and synthesize content to show the right data to right people at the right time. With content developed in a consistent manner across all platforms and resources, your team receives aligned drug information no matter when or how they access it. This helps:

  • Improve communication
  • Reduce confusion
  • Enhance patient care

Learn more

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